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Rural Health Services Disruption: An Evaluation of Nursing's Professional 'Positionality'.

Jessica G Smith¹, Sharon Laver²

¹University of Texas at Arlington College of Nursing and Health Innovation, Arlington, Texas, USA.

Nursing Philosophy : an International Journal for Healthcare Professionals

|February 19, 2026

Summary

Rural health services face significant disruption globally. Nurses can advocate for equitable access, transforming challenges into opportunities for systemic change in rural healthcare.

Keywords:

codes of ethics health facility closure human rights positionality rural health services rural nursing social contract

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Published on: January 9, 2026

Area of Science:

Global Health
Nursing Practice
Rural Health Systems

Background:

Rural health services are globally challenged by disruptions like supply chain issues, workforce shortages, and climate events.
Rural hospital closures in the US highlight systemic issues rooted in socio-political impasses and economic factors.
Nurses in disrupted rural areas face significant burdens navigating systemic barriers while providing care.

Purpose of the Study:

To explore the philosophical groundwork needed for a professional nursing stance on rural practice.
To position nursing as a leader in advocating for equitable rural healthcare access.
To encourage nurses to move from being reactive to proactive agents of change in rural health.

Main Methods:

Philosophical analysis of nursing's professional positionality in rural contexts.
Examination of the ICN Code of Ethics for Nurses regarding social contract and advocacy.
Conceptual framework development for professional nursing engagement in rural health reform.

Main Results:

A defined professional nursing positionality is crucial for addressing rural health disruptions.
Health as a human right provides a foundation for nursing advocacy in rural areas.
Collective nursing action can drive systemic reforms for equitable rural healthcare delivery.

Conclusions:

Nurses must define their professional stance to effectively navigate and lead change in rural health.
Advocacy grounded in ethical principles can promote equitable access to services for rural populations.
Engaging as a professional group empowers nurses to influence systemic reforms and overcome socio-political divisions.